1983, 04-20 Permit 83A-3123 Heat PumpPLAN NUMBER
1
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
PERMIT NUMBER
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
APPLICAr COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
r 1/, �3/.4tf f�fr LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
Pzn(!
R-
<ADDRESS
4.
BLOCK (SUBDIVISION
CI NTRACTOR�
QRESS
DESIGNER
5' ADDRESS
PHONE {
ZI
PHOIVE��YY,J�y
s i79-76/
P}1ONE
PARCEL NUMBER/S
Actual Set Backs in Feet
North (South
East
'West
Size of Parcel 1 Zone Classification
Type Const.
Occupancy
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation I Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
O NEW
❑ BLD.
DESCRIBE WORK
8. 1�-
VALUATION
9.
O ALT.
O PLMB.
❑ AD'N.
-E1--MECH.
❑ RPL.
O M.H.
fl;(). //Le v_k4_,
SOURCE
OF
UTILITIES
GAS
ELECTRIC
❑ MVE.
❑ POOL
; 21 y�f�
WATE
0 OTHER
SEWER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Enum. Dist.
Location (Area)
Ownership
Public 0 Private ❑
USE CODE
Req'd.
hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The gra ti g of a permit does not presume
to give authority to violate or cancel the provisions of any other state or Ioc 11• regulatinconstructioj or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPEC I Ir NS
7
14 DATE OF APPLICATION % SIGNATURE OF APPLICAN
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
Rec'd.
Not Req'd.
FEES COLLECTED
Single $
Building
Plumbing
-Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ //
/%i
04* * 1 4,00
*11I,006
A *0,00
31 2.22
04-20-83
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. , ,
31;2.3z O
14;Oj0a� —
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL